Pancho - LOP-LUZ-02

Code: LOP-LUZ-02
Mercy ID: V-02138-12
Encounter Date: 01/18/2006
Last: Lopez
First: Luz areli
DOB: 04/29/2002
County: Gwinnett
Street: 5133 Westover Circle
City: Lilburn
State: GA

Zip

30047-

Cell

(770) 378-8290

Family Status

Attached youth

COB

USA

Gender

Female Child

Housing

Not Homeless

Education Level

Child, not in school

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Lorena Valencia	04/06/1979	Mexico
Father	Jose Refugio Lopez	05/05/1973	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Mother
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: Volunteer
Data Entry: R. Gonzalez